1. Field of the Invention
This invention relates to an improvement for a model and simulator for practicing ophthalmologic surgical techniques, including cataract surgery, and an apparatus for simulating the human eye structure, namely the human anterior lens capsule, to practice certain ophthalmologic surgery techniques.
2. Description of Related Art
Cataract surgery has evolved over the years as a result of contributions from many notable physicians as well as technological advances, which have led to the elegant procedure which is now commonly referred to as phacoemulsification or quite simply “phaco”. Like a carefully choreographed dance within the eye, the many intricate steps to replace the crystalline lens must happen in a precise and orderly fashion. Each step in the process, while important in its own function, is vital for the success of the subsequent maneuvers and as such assumes a greater role towards the completion of an uncomplicated procedure. A complication during the early steps of surgery can lead the surgeon to stray off course, and a cascade of events may follow which could ultimately result in a sub-optimal result.
Microsurgery in the form of phacoemulsification has a very steep learning curve which requires hands-on training. It is not possible to learn and become proficient with the techniques from reading text, watching film or even observing in the operating room. A true appreciation for the complexity of the techniques and their potential complications can only be gained through actual surgical experience.
Cadaveric pig eyes are widely used in wet labs for teaching various steps of ocular surgery. However, there are difficulties associated with procurement and disposal of pig eyes, they are messy and contaminate the instruments, and they do not resemble the in-vivo human anatomy as closely as needed. This is especially true in regards to the anterior lens capsule where ophthalmology residents often attempt their first capsulotomies.
Model eyes have also been used but they all have significant limitations in terms of realism. Most model eyes do not incorporate ocular movement and if they do it requires a cumbersome and costly supporting apparatus. Most importantly, the realistic feel and tearing properties of the anterior capsule are inadequate in all currently available models. Further, in many cases, the dimensions of the anterior chamber are not to scale, which limits the utility of these designs.
More recently, electronic simulators have been developed which can provide excellent tips and guidance. However, these systems are extremely expensive and, more importantly, do not provide a realistic feel for manipulating instruments inside the eye.
Arguably one of the most difficult steps of phacoemulsification to master is the creation of the continuous curvilinear capsulorhexis or “CCC”. Occurring prior to the use of the phacoemulsification probe within the eye, the successful creation of a CCC is vital to the safety of the procedure and the long-term stability of the lens implant within the eye.
In this continuous curvilinear capsulorhexis surgical technique, the surgeon creates a small incision with a cystotome (a bent needle type surgical tool) in the center of the anterior lens capsule to form a flap. Grasping this flap of tissue, the surgeon makes a tear in a circular or curvilinear fashion.
However, this is a difficult procedure to master, and if the surgeon does not reposition and re-grasp the flap of tissue appropriately and continue to tear in the desired circular fashion, there is the risk of creating an unwanted radial or downhill tear.
In addition, during surgery, there is the possibility of wound distortion and loss of viscoelastic material, which would in turn cause the surgical area to change from a relatively flat surface to a rounded configuration. This rounded configuration can further increase the possibility of developing an unwanted radial tear of the anterior lens capsule during this procedure.
The new “Simulorhexis™” teaching tool is now available to help ophthalmology residents understand and practice the technique of creating a circular caspulorhexis. Because the Simulorhexis device hones in on this one crucial step of phaco surgery, it provides the most realistic way to master the CCC technique prior to live surgery.
This invention presents a new and improved teaching tool to help ophthalmology residents understand and practice the technique of creating a continuous curvilinear capsulorhexis. This invaluable surgical teaching and practicing tool is easily accessible, portable, lightweight, and accurately mimics the physical feel and touch of human eye anatomy.
From the preceding descriptions, it is apparent that the devices currently being used have significant disadvantages. Thus, important aspects of the technology used in the field of invention remain amenable to useful refinement.